Exercises for upper back pain

People complaining of upper back pain, whether they realise it or not, will most often be referring to pain in the region of the thoracic spine.  The thoracic spine is made up of 12 vertebrae that sit roughly from the level of your belly button, to the junction of the neck and shoulders.  When viewed in profile, it is the convex curve between the two concave curves of the neck and lower back.

In the modern way of living, the thoracic spine is prone to slouching, and thus the discomfort people feel in this region is due to over-stretching of spinal ligaments and excessive compression of the intervertebral discs.

Below is a series of thoracic spine stretches and mobility exercises.  Patients often ask, “How often should I do these exercises?”  The build-up of postural discomfort throughout the day usually prompts some sort of alleviating activity towards the afternoon and early evening.  Since upper thoracic discomfort is largely postural in aetiology, it makes sense that performing these exercises, at least once, towards the end of the day would be more beneficial.

If one was really wanting to address postural strain and discomfort however, it would be far better for one to integrate these spine sparing activities more routinely.  Rather than pressure oneself to perform a certain number of sets and repetitions daily, perform these exercises regularly throughout the week either in anticipation of the onset of thoracic pain, or at the moment that pain arises.

Finally, before attempting these exercises, remember that not all of these will be suited to every individual’s condition.  Some may be either too challenging or not challenging enough.  Consult with your health professional as to the appropriateness of these suggestions for your particular injury of condition.

*DISCLAIMER: This discussion does not provide medical advice. The information, including but not limited to, text, graphics, images and other material contained in this discussion are for informational purposes only. The purpose of this discussion is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read in this blog.

Lower back pain exercises

Lower back pain presents in so many different ways.  On the contrary, two people with the same set of symptoms may respond to completely different treatment plans.  Perhaps the one thing all of us have in common, is our fight against gravity.  We are all subject to the compressive stress of gravity and therefore, the overwhelming majority of us may benefit from spinal decompression.

The following set of exercises, is an easy-to-do at home routine that will unload your spine from the compressive stress experienced during prolonged sitting, standing and existing on planet Earth.

More information about spinal decompression exercises and how to use a back block.

Spinal Decompression Exercises

Each and every one of us, for the rest of our lives, will be engaged in the battle against gravity.  It is a constant force applied to us every single day.  Coupled with the hours we sit, the sports we play, and the unexpected trips and falls we might endure, this translates to massive compressive forces placed upon the spine.

To deal with this, the spine has ‘discs’ between each vertebra.  They are fluid-filled shock absorbers and prevent bone-on-bone friction.  Since they do not have a blood supply, nourishing the discs occurs via osmosis.  Movement throughout the spine is thus vital to preserve and feed these structures, so that the discs can prevent excessive wear and tear to the vertebral column.

Incidental spinal movements throughout the day create a physical pumping effort which shunts nutrient-bearing fluids in, and stale fluids out.  Well-hydrated discs become plump which gives better bony separation and ultimately renders the spine more able to accommodate compression, impact and jarring.

The force of gravity means the discs naturally lose fluid throughout the day – people can lose up to 2cm in height by the end of the day.  Sleeping horizontal at night allows the natural fluid exchange within the discs to be carried out – fresh nutrients are drawn in, whilst stale fluid is expelled.

Prolonged sitting is a risk factor for maintain healthy discs.  In the first two hours of sitting, one can lose up to 10% of intradiscal fluid. Slumped sitting is particularly bad for the discs, as is any low activity posture.

The majority of back pain that exists today, is often due to compressive forces applied to the spine. In the age of chronic sitting, performing spinal decompression exercises daily may serve the overwhelming majority of back pain sufferers.

Using a back block is an easy and effective way to perform spinal decompression.  Lying backwards passively over a block exerts lumbar traction and both stretches the compressed disc wall and passively elongates tight local muscles and ligaments that have tethered and contracted the spine down.  This method works by stimulating pressure changes within the intervertebral discs by alternately loading and unloading the discs within their physiological range.  The physical separation of the spinal segments also counters the fluid loss and the slow deflation of the discs.

Using the back block

  1. Lie on the floor on your back with your knees bent so that your feet are touching the floor.
  2. Lift your backside off the floor and slide the block, on its flattest edge, to rest lengthways under your sacrum (the hard flat bone at the base of your spine).
  3. Straighten your arms above your shoulders to rest on the floor, then straighten out one leg at a time until both legs are relaxed.
  4. Remain in this position for 60 seconds only.  Expect some initial discomfort as your body adapts to the position.
  5. For a greater effect, you may progress to using the block on its second highest edge on subsequent sets.  Always start using the lowest edge first.
  6. After 60 seconds of lying over the back block, bring your arms back down to your sides.  Then return your legs, one at a time, to the starting position (take care as this can be uncomfortable).
  7. See the following pictures to reference the correct positioning of the block.

 

The challenge when in the final back block position, is to let go of all muscular tension.  If you are suffering back pain, your body may resist completely relaxing your back over the block.  Take your time.  With each exhale, attempt to let the muscles around your pelvic floor, hip flexors and lower back give way, so that you can begin to feel the traction sensation building up through your spine.

Pelvic rock

  1. Lie on your back with your knees bent and feet on the floor. In this position note that your lower back is somewhat raised (or arched) off the floor.
  2. Flatten your back against the floor (push fairly hard) and then relax.  Do this fairly quickly for about 30 seconds, aim for 30 repetitions.

Having just followed the back block routine, your back may now be feeling slightly sensitive.  Traction through the spine is a force we are not usually accustomed to. It can be a mildly painful experience following this decompression exercise.  The pelvic rock is a gentle way of alleviating any immediate discomfort experienced through the lower back after using the back block.

Knees rocking

  1. Raise your knees, one at a time, towards your chest so that your thighs are parallel to the floor.  Cross both ankles and relax your knees outwards.
  2. Place your hands around the outside of each thigh to hold your knees so that all the weight of your lower body is held in your hands.
  3. Gently oscillate your knees towards your chest for 30 seconds, do this rhythmically as if rocking a baby to sleep.

The knees rocking movement is an excellent way to restore lumbar flexion range of motion.  This helps to loosen the large lumbar erector spinae muscles of the lower back and facilitate further, the imbibition of fluid into the intervertebral discs.

Reverse curls

  1. Start in the same position as for the knees rocking exercise but instead, interlace your fingers behind your head.
  2. Using your lower abdominals, bring your knees towards your chin, attempting to lift your backside off the floor.
  3. Try to keep your stomach pulled inwards as you lower your legs perpendicular to the floor.  Ensure your thighs do not pass beyond this return point (90 degrees).  This will cause your back to arch and potentially become painful.
  4. Do 15 repetitions.

The reverse curl exercise activates the abdominal corsetry that serves to lift your spinal segments off one another.  In this way, the lower abdominals act as the body’s own spine sparing function enabling spinal decompression.

Child’s pose

  1. Start on all fours, then sit your backside onto your heels.
  2. Keep the knees pointing outwards at roughly 45 degrees, then lower your torso forwards with the arms stretched out in front of you.
  3. Relax in this position for up to 30 seconds.

This yoga pose has many benefits but is used in this instance as another means for spinal decompression.  If you have a history of hip, knee or ankle injuries, you may struggle to morph your body into this position.  If so, some simple forward bending off the edge of a seat, or toe touches will suffice.  See the below suggestions.

Forward bending (below left), Toe touches (below right)

 

Since compression builds up in our spines throughout the day, the best time to perform this routine is at the end of the day.  You can however follow this routine as many times as you like.  Remember, in the mornings after sleep, you would have already been somewhat decompressed throughout the night.  It would thus be less effective doing these exercises upon waking.  Ideally, you would attempt to do this routine between 12 and 3pm, and just before going to bed.

Back blocks are available for purchase at Cartwright Physcialtherapy.

Active Release Technique Sydney

Active Release Technique Sydney

Active Release Technique [ART] is available at Cartwright Physicaltherapy, Ground Floor, 157 Walker Street, North Sydney, NSW.

Tom Cartwright, Sports Chiropractor, has been practicing ART since 2008 in conjunction with a multitude of other therapies. He is a Masters ART provider – currently full body certified with additional certifications in nerve entrapment and complex protocols.  Above we see a recent photo of Tom demonstrating an Active Release Technique protocol  at the Masters ART course in front of the founder, Dr Michael Leahy in June 2018.

ART is a movement-based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART. These conditions all have one important thing in common: they are often a result of overused muscles and otherwise referred to as repetitive strain injuries (RSI).

 

WHAT DOES A TYPICAL ART TREATMENT INVOLVE?

ART is a hands-on technique. After careful examination of your injury, assuming it is related to soft tissue structures, the practitioner uses carefully positioned hand contacts on your body to affect treatment.

For example, in the case of tennis elbow, the practitioner will place your hand and forearm into a specific position such that the wrist extensor muscles are in their shortest position. The practitioner places his/her contacts very specifically on a targeted muscle. He/she will then have you perform a specific [active] movement that sees the specific muscle move into its most lengthened position. Alternatively, the practitioner may choose to perform the specific movement him/herself while you remain passive.

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Each muscle protocol may be administered anywhere from 3 to 6 times. You can expect a number of different muscle protocols to be used for a particular injury. The skill of an ART practitioner lies both in the application of the technique, as well as the ability to diagnose which areas to treat in the resolution of an injury.

 

HOW DOES IT FEEL? 

Essentially, ART is a combination of massage and stretching. The sensation experienced by a patient could be described as a ‘sweet pain’. This means that whilst there might be some discomfort, there is an overwhelming feeling that there is therapeutic benefit. Patients will usually instinctively know that the practitioner has correctly identified the key area of concern, and will crave more of this ‘comfortable discomfort’.

Patients should feel well supported by their practitioner, being able to perform the instructed movements with relative ease. It should never feel agonisingly painful. Expect to feel some soreness in the area following your first consultation (3 to 5 out of 10 pain scale). This soreness may last into the next day and you should feel ready to receive further treatment two to three days later.

 

FREQUENCY OF TREATMENT?

Patients always want to know how quickly they can be fixed. There are stories of people being cured from their injuries after just one or two sessions. It is highly unlikely there is any truth to these stories.

Repetitive strain injuries take time to develop. By nature, it is many repetitions that lead to the state of injury. Fixing these injuries is the same – it takes time to resolve them. In addition to a period of rest, regardless of what your particular injury is, at the very least you will require four to six sessions of ART.

Treatment by a skilled ART practitioner may see positive changes in as little as one or two sessions. The frequency at which sessions are conducted is crucial. ART therapy works best with no more than two to three days in between treatment. Too much time passing between sessions will thwart the healing process. Once you start treating soft tissue injuries, you need to keep the progress going. It’s akin to keeping fit – exercising once a month is not effective whereas three times per week is.

If you cannot commit to a proposed treatment plan – do not waste your time starting. Wait until there is a period of time in your schedule when you can commit to regular treatment.

 

ART is just one of many techniques offered at Cartwright Physicaltherapy. If you are suffering a musculoskeletal injury, take the time to research other techniques. There is no magic bullet, and so you will most likely find a combination of therapies is the best means of treatment for your condition.

Get your injury addressed today by booking online at Cartwright Physicaltherapy.

Angus Phelps Chiropractor North Sydney

Angus Phelps Chiropractor North Sydney

Angus is an active lifestyle enthusiast and has an extensive sporting background having played rugby union for the Manly Marlins for 12 years. His personal sporting endeavours left him plagued with injury and, as a result, is fully appreciative of the frustration and longevity of pain and injury. Angus offsets his own sporting woes by hiking, swimming at North Sydney Olympic Pool and surfing poorly at Manly Beach. 

Angus is an advocate of multi-modal therapy, a component he reiterates in his own practice, offering a pro-active brand of healthcare that is unique and personalised to the individual. He emphasises communication so that his patients can make informed decisions in a collaborative approach to their care. 

Angus has a keen interest in the management of all musculoskeletal concerns – from work and posture related discomfort, to sports injury prevention and management. He has worked alongside various sporting clubs inclusive off Manly-Warringah AFL, Narraweena Rugby League and Macquarie University Rugby Union. 

After studying a Bachelor of Chiropractic Science and Master of Chiropractic degree at Macquarie University, Angus graduated in 2017.  He is currently a member of Chiropractic Australia (CA) and the Chiropractic and Osteopathic College of Australasia (COCA). Angus is dedicated to continued professional development such that he can offer his patients a well-rounded and contemporary style of care.